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COPD Exacerbation

What is a COPD exacerbation?

A person with chronic obstructive pulmonary disease (COPD) experiences long-term and progressive damage to their lungs. This affects air flow to the lungs. Doctors sometimes call this condition chronic bronchitis or chronic emphysema.

Those with COPD can experience periods when their symptoms are much worse than usual. This is known as an acute exacerbation. A person undergoing a COPD exacerbation may need to seek medical help at a hospital.

COPD exacerbations can be harmful because they can cause further damage to the lungs. If you’ve been diagnosed with COPD, preventing an exacerbation from occurring can help you live a healthier life and reduce your risk of death.

What are the symptoms of a COPD exacerbation?

Symptoms

If you have COPD, activity will typically leave you short of breath. You may not be able to do all the physical activities a person without it can do. This is because the condition makes it hard to breathe. During a COPD exacerbation, your symptoms can get much worse than usual.

Examples of COPD exacerbation symptoms include:

Average oxygen level
The oxygen level of a person without COPD is 92 to 100 percent. Someone with COPD may have a slightly lower average oxygen level.
  • breathing in a fast and shallow pattern, as if you’ve just exercised very intensely
  • coughing
  • experiencing shortness of breath at rest or with minimal activity, such as walking from one room to another
  • feeling excessively sleepy or confused
  • having lower oxygen levels than normal
  • noticing increasing amounts of mucus, which is often yellow, green, tan, or even blood-tinged
  • wheezing more than usual

What COPD exacerbation symptoms require emergency care?

when to see a doctor

Your lungs are responsible for exchanging oxygen with carbon dioxide. Carbon dioxide is left in your body after it uses oxygen. A person with COPD has more difficulty making this exchange because their lungs don’t work as well. This could lead to a buildup of carbon dioxide.

If carbon dioxide builds up in your body, it can become deadly. Symptoms of too much carbon dioxide in your body include:

  • confusion
  • severe headache
  • difficulty walking even short distances
  • a hard time catching your breath

If these symptoms occur, it’s important you seek immediate medical attention.

What causes COPD exacerbations?

Causes

A COPD exacerbation is usually triggered by inflammation in the lungs. Infection or irritants can cause this inflammation. Examples include:

  • pneumonia
  • flu
  • seasonal allergens
  • air pollution
  • smoke

If you have COPD, it’s important to take every step possible to avoid lung infection, such as getting flu shots annually. You’ll also need the pneumococcal vaccine.

However, about 33 percent of COPD exacerbations don’t have a known cause.

Can COPD exacerbations cause other conditions to develop?

Complications

Because COPD causes limited lung function, this can keep you from exercising or moving around as much.

Limited lung function also makes you more likely to get an infection. Getting a cold or flu can be more dangerous and cause more severe symptoms.

Some of the known complications associated with COPD include:

  • depression, as having COPD can affect your ability to do things you enjoy
  • heart problems, such as heart disease and increased risk for heart attack
  • high blood pressure in the arteries of the lungs, known as pulmonary hypertension
  • lung cancer, because those with COPD often were or are smokers

How are COPD exacerbations treated?

Treatment

Treatments for COPD exacerbations can depend on how severe your symptoms are. Most people with COPD will start to notice a pattern for their symptoms. If you notice the symptoms of an exacerbation coming on early enough, you can get treatment before your symptoms worsen.

Home treatments

If your symptoms aren’t severe, your doctor may prescribe treatments for you to use at home. Examples of these include:

Antibiotics: If bacteria caused your respiratory infection, taking antibiotics can help to slow the infection or stop it from getting worse.

Inhalers: When the small, tree-like parts of your lungs known as alveoli get narrow or fill with mucus, it’s harder to breathe. These medications help to open the airways and make it easier to breathe.

Examples include albuterol-ipratropium (DuoNeb) or levalbuterol (Xopenex).

Steroids: These medications are designed to reduce inflammation in the lungs that leads to swelling and narrowing of the airways. An example of this medication is methylprednisolone (Medrol).

Emergency treatments

At a hospital, your doctor may provide additional treatments to support your breathing. One example is the use of a continuous positive airway pressure (CPAP) device to help keep your lungs open.

Your doctor may put you on a ventilator to help you breathe. In this case, you’ll stay in an intensive care unit until your infection clears up or your lungs become less inflamed.

Can COPD exacerbations be prevented?

Prevention

You can help prevent COPD exacerbations by following certain self-care practices. These include:

  • avoiding exposure to lung irritants in your home such as kerosene heaters
  • avoiding large crowds during cold and flu season to prevent getting sick
  • drinking plenty of fluids to prevent mucus from becoming too thick
  • getting a yearly flu shot to prevent a respiratory infection
  • keeping regular appointments with your healthcare provider, such as a pulmonologist who specializes in caring for the lungs
  • monitoring your oxygen levels whenever possible (Some people use a small device called a pulse oximeter for this purpose.)
  • practicing healthy habits, such as getting enough sleep at night and eating a healthy diet
  • getting a pneumonia or pertussis shot when your healthcare provider recommends it
  • quitting smoking if you currently smoke or avoiding secondhand smoke
  • washing your hands frequently and using hand sanitizer to prevent the spread of germs

What is the outlook for COPD exacerbations?

Outlook

The average person with COPD has an exacerbation about 1.3 times a year.

COPD exacerbations can be deadly. If your lungs are functioning poorly, you might not be able to breathe without a ventilator. It’s also possible that a ventilator couldn’t provide enough support for your lungs.

Doctors classify COPD in four stages, from mild to severe. Because the condition is a chronic one, you may progress through each of the stages. However, this usually occurs over the course of many years.

Preventive self-care measures like the ones mentioned earlier can reduce the likelihood of an exacerbation. Ask your doctor about additional steps you can take to prevent COPD exacerbations.

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